Can losing weight help your kt/v when you are on pd(the cycler)

[mike22]

MY Kt/v has drop from 1.53 to1.34. It was close to being the minimal requirement. I am 15-20 pounds(dry weight) over my usual dryweight. Which is between 140-145 pounds. Now I'm about 150-160 pounds.  Can losing dry weight help my kt/v?

[jeannea]

I wish I knew the answer to this. My speculation is that losing weight might help but I don't know. Can't hurt. Unfortunately I do understand that for some people PD doesn't work well and for all of us it eventually stops working. How long have you been on it and what does your nurse say?

[mike22]

I haven't asked my nurse but i started pd this year in oct.

[lmunchkin]

I dont think it can hurt at all, as long as you don't go too low.  In relation to Ktv, Im not sure that affects that one way or the other.  Ktv has to do with clearance of fluid & toxins built up in your system.  It tells them how well your dialysis is going, ie do changes need to be made to better it.

The only correlation would be the fluid & the weight loss, but I do not think Ktv is affected at all by your lose of weight.  I may be wrong though!

lmunchkin
 

[Annig83]

In my experience, I haven't noticed a difference when I gain or lose weight...water or dry.  MY Ktv level has been getting better, but I started D in May of last year.  My doctor told me it's because my body has finally adjusted to the dialysis...or became stabilized on it? I am considered overweight in general so recently I lost 15 pounds but my Ktv level stayed stable.Because I am on a transplant list, my doctor suggested losing some poundage anyway.  Don't know if that helped at all, but I wish you luck!

[amanda100wilson]

I can't really see how losing weight will help.  I don't know what percentage of toxins are related to metabolic waste, and of that percentage, how much is specific to fat, but as others have said, fluctuations of weight had no impact on Kt/v when I was doing PD

[Kammie]

Ok..I feel really stupid asking this, but I'm going to anyway!

What are y'all (yes, I'm from the South!) referring to regarding KT/V?  I've been on PD for about 6 months and I've never heard this term..?

Thanks!

[jbeany]

What are y'all (yes, I'm from the South!) referring to regarding KT/V?  I've been on PD for about 6 months and I've never heard this term..?

From a quick info search:   "Kt/V is defined as the dialyzer clearance of urea (K, obtained from the manufacturer in mL/min, and periodically measured and verified by the dialysis team) multiplied by the duration of the dialysis treatment (t, in minutes) divided by the volume of distribution of urea in the body (V, in mL), which is approximately equal to the total body water. The correction of total urea removal (Kt) for volume of distribution is important because, in a large patient, a given degree of urea loss represents a lower rate of removal of the total body burden of urea (and presumably of other small uremic toxins)."

In short - it's meant to measure how much urea (one of the things that builds up when your kidneys aren't working properly) is being removed from your blood when you do dialysis.  I'm not sure how it differs as a measurement from hemo to pd, when you aren't using a manufactured filter to clear toxins.

As for losing weight making PD more effective - I have no idea, having never done it.

 I know I did better on hemo the more weight I lost.  I always figured if I was getting the same amount of cleaning regardless of what I weighed (since I was running with the biggest possible filter I could get, at the highest pump speed I thought my graft could reasonably handle, and always for the same amount of time) - the less I weighed, the less there was of me that needed cleaning.  The same gallon of hot soapy water will do a better job of cleaning a little floor than a big one!

[lmunchkin]

Kammie, in regards to PD I believe that is what they have a 24hr urine specimens for.  I think when you do that test where you draw from your drain bags and take to clinic is when a Ktv is determined.  Now it has been awhile, but I believe Im correct on that.  Its just a test to determine whether you are getting adequate D, whether hemo or PD.
I think they called it 24hr Kenetics when we did PD.

lmunchkin

[Joe]

lilmunch, you are correct. We on PD measure our Kt/V with a 24 collection and evaluation of everything we produce for 24 hours. And when you're running 14 liters of fluid through your system a day, that's a lot! My Neph looks for a value over 1.7 as an acceptable level. It used to be over 2.0, but that got modified late last year.

[lmunchkin]

Thanks Joe, Its been so long, but I figured that was it.  I had heard they dropped the values down some, but wonder though, was that a good idea.  The whole objective here is to get "Good" Dialysis.  So why did they drop the values?  I mean, it really doesnt effect my husband, cause he will get a good cleaning regardless, but for the rest of you, I wonder. 

Do you think they should have dropped the values?  I personally feel, if a person feels good & can function normally with what they get, should be the VALUE they should go by.  But in a realistic world, that is not going to happen.  No money in that!!!!!

God Bless,
lmunchkin